Music Therapy (A Socially Phobic Shrink Takes on a New Therapy Medium)

I had lunch with Dr. Pete and Dr. John this week. At the behest of John we had to have Italian food of course. The guy eats nothing but pasta. He probably chews pasta-flavored gum.

Near the end of the meal Pete tapped his fork against his glass like you’d see at a wedding. Were John and I supposed to kiss?

“I have two small announcements to make,” Pete said.

He’s been self-medicating his anxiety with drugs and alcohol, I know it. He’s going to rehab. or A.A. Finally!

“You’re coming out of the closet” John said.

“No,” Pete said.

“You’re a tranny?”

“No!”

“You’re adopted? Your wife is leaving you?? Your kid lost a leg? It must be something I can make fun of!”

“I wanted you both to know that I’ve begun group therapy for my Social Phobia.”

This was huge. Pete had been on medication and in individual therapy for years, but neither was working. He had even seen an acupuncturist, life coach, herbalist and several psychics all to no avail. As strange as it may sound, group treatment is the method of choice for Social Phobia. It’s just that Pete could never bring himself to sit in a room full of other adults without having a massive panic attack.

“So we can finally go to restaurants that have more than 4 people in them without you swallowing your own vomit at the table?” John asked.

“Yes. Well, hopefully. It’s not that I choose to vomit, it’s simply an involuntary contraction…”

“Pete, what’s the second announcement?” I asked.

“I have started outside training to expand my practice to include Music Therapy.”

“Music therapy? What the hell is that?” John said.

When Pete is confronted his anxiety begins to rise. He closed his eyes, paused, breathed deeply and spoke. “According to Medscape.com, there are two types of this therapy: receptive and active. In receptive music therapy, a person listens to music with a therapist, and the music can be used for relaxation and motivation and as a bridge to emotions, cognitive work, personal development, and self-reflection.”

“Are you quoting verbatim from the site?” John asked.

“Yes and don’t interrupt or you’ll break my concentration!” Pete said as his eyes snapped open.

Another deep breath, eyes closed. “In active music therapy, the patient and therapist play improvisational music together. The patient does not need to be a skilled musician. Gradually you draw out from the patient something musical and build a piece of music together that can be used as the basis for a discussion, or it can be the therapeutic agent in itself.” Seemingly relieved he opened his eyes and smiled like one of those kids who spell “brachypterous” correctly on ESPN’s National Spelling Bee. “It might be great for people who don’t respond to traditional talk therapy.”

Unfortunately only a small number of studies have been done. However there may be a growing body of research to support this type of work as an alternative treatment to depression. Pete is studying both approaches but prefers active music therapy. I’ve never seen him play an instrument, but the mental image of a socially phobic Pete holding a piccolo or perhaps a giant sousaphone in his Manhattan office brought a smile to my face.

“Well it sounds pretty fucking stupid to me,” John said. “What are you gonna play with your patients Pete? Skin flute?”

I don’t know what I think about this whole Music Therapy business. It is certainly unorthodox and my first reaction was pretty similar to John’s. However, depression is a tricky animal and it’s certainly not “one size fits all” when it comes to treatment. Anti-depressants work for some people but not all. The same can be said for Freudian analysis and cognitive-behavioral therapy. Even combining therapy and medicine doesn’t always work. In other words, mental health professionals need to always be developing and studying treatments to come up with ways to help everyone.

So who are John and I (especially John) to say that it’s a bad idea? I see a fair amount of teenagers who talk passionately about music, how much it means to them, how it speaks to them. I’ve met a few composers who talk about how their work is the most important aspect of their life. Maybe music can in fact be a therapeutic tool that can be measured and studied. Most psychologists are trained with the Scientist-Practitioner model, which teaches that research is meant to be a guide into how we practice. If the research continues to build on Music Therapy I may just support Dr. Pete as he and his clients discuss the merits of Neil Diamond together.

This entry was posted on Thursday, January 31st, 2008 at 3:27 am and is filed under Blog. You can follow any responses to this entry through the RSS 2.0 feed.
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I’ve had Music Therapy for a couple of years, mainly to work on anger management issues. It was basically me, the therapist and a bunch of stuff that made noises. Since I was an angry kid, I just focused on the ones I could bang and punished, I meam, played them to take out my hatred for everything. I’m much, much better now but I can’t say it was because of the therapy.

Hi Dr Rob
I’m suprised to fin that you are unfamilar with Music Therapy. Several univercities around the world offer prgrams in the filed. For starters I’d sugjest you check out musictherapy.org for the American Music Therapy’s website. Also some books :
The Biomedical Foundations of Music as Therapy by Dale Taylor, Case Studies in Muisc Therapy, Edited by Kenneth Bruscia, And also in the more popular catagory books by Oliver Saks. I think you will be plesantly suprised at the weath in information you will find. Good Luck!
Dr. Rob Note: Thanks for the resources! I was aware of it as a field but did not know it was being studied specifically for depression. You’d be surprised at how much I don’t know…

My University is one of those schools that offers courses in it, and according to that musictherapy.org site, even graduate programs. I guess it makes sense. On campus the psych program is pretty big and so is the music school, so I guess it makes sense.
I’ve talked to a few kids on campus who are in it about it in passing conversation, and they seem pretty convinced about the whole thing. Some even came specifically to our school for the program.
But I still reserve judgment. I’m open to it, but I won’t buy in until you show me a body of research. As far as I’ve heard (not that I’ve looked or anything) no such research is taking place (or at lest getting any attention) on this campus.

Don’t MPS instances present in multiples of 7 personalities or something? IE Rob would have 7 personalities, and potentially his personalities could have MPS as well – so John could have 7 personalities of his own?
I think if Dr Rob had MPS, pete would be a bunch more anxious.

I’m not going to comment on the music therapy part of this article, only the humor which yet again I find subtly hysterical.
Favorite lines
So who are John and I (especially John) to say that it’s a bad idea?
to celebrate your newfound combination of Carl Jung and Barry Manilow, I’ll pick up the check.”
He probably chews pasta-flavored gum.
Additionally, you’re a genius with dialogue.

Music therapy is mentioned in The Singing Neanderthals. The whole premise of this book (which I haven’t finished) is that before language, before music, prehistoric man had a proto-language which used elements of both. It’s a pretty interesting book, for example it goes over some case studies of people with brain damage who can’t talk but can sing, and vice versa.

I’m not sure about the efficacy of music therapy, but I suspect that it will help Dr. Pete with his social anxiety. Creating music with others is a very social and intimate experience. Perhaps this non-verbal interaction will help both Dr. Pete and his clients. I’ll keep my fingers crossed!

So we know that you are iffy about music therapy…but what about art therapy Dr. Rob? 🙂
Dr. Rob Note: Again I have to plead ignorance, at least in terms of it being a structured therapy for specific disorders, but I’d love to hear more…

I spent all four years of high school planning to study to be a music therapist in college. In the end it didn’t work out with my circumstances, but I did a senior research project on the subject. I held a “session” with the special education class at my school and did some musical activities: letting them play tambourines, xylophones, etc., putting on songs and seeing how they physically reacted to it [most of them danced or tried to dance, even those with limited mobility], and giving them paper and crayons to see what they drew when they heard songs portraying different moods. It was absolutely fascinating and so much fun.
Music therapy is also commonly used with alzheimer’s patients. In sessions like that the therapist would use music that may have been prominent in the patient’s past to help trigger long-term memory. Over time, you would ideally use the audio triggers to rebuild memory strength and help the patient overcome severe lapses.
There are some studies that show music to be used as a pain reliever, citing that the vibrations ease nerve agitation. Also, something that wouldn’t necessarily be constituted as “therapy,” people use music as a motivator to help them get through every day activities such as working out, studying, cleaning, etc.
There is a fantastic book that I used for my research project called “The Tao of Music” by John M. Ortiz, if you find yourself really interested in the subject.
Music is not a cure-all, but it’s still incredible. I personally suffer from manic depression and sometimes listening to a song that expressed all the emotions I don’t have the energy to release was the only thing that got me through my day.

I think music therapy is an interesting idea to consider. An approach that I could see myself getting into is listening to music and then discussing the lyrics. I’ve definitely felt very powerfully affected by songs before. Sometimes it feels like the singer/songwriter just “gets it”, just completely clicks with my interpretation of whatever situation. Well, why is that? What is it about this specific word choice or tone of voice really makes me feel validated? Maybe discussing those questions could elucidate feelings. Also, if writing talent and humour were expressed in terms of physical attractiveness, I think you’d rank somewhere around Tom Welling, Pierce Brosnan, and Clive Owen, which has now turned into a personal and awkward way of saying, I like your writing.

I would prefer to be singing or playing my violin than talking during therapy… I don´t think is such a bad idea, specially when some people are not able to open up and spend most of the therapy time sitting quietly hoping for those long 45 minutes to be over.

I actually prompted/requested receptive music therapy with my therapist without knowing of its existence. Basically, for me, music is a language. I can use it to communicate feelings that I cannot find words for. I have a terrible time finding words to label the things I feel in therapy; I get physical sensations of pain in my chest, stomach, throat, and have absolutely no idea what the emotions are when asked. So, sometimes, I pull out my iPhone and play a song that, I feel, better explains where I’m at. Or, we use the song as a starting point for discussion (e.g., this song has been in my head all week because it’s so my life right now… we listen to it, we discuss how I relate to it.)